—HITAC — task forces and standards: ONC is floating a flotilla of new task forces to issue recommendations on its new rules, the office stated at Wednesday’s Health IT Advisory Committee meeting. Committee members are kind of curious about the government’s choices on standards to support.

eHealth tweets of the day: Genevieve Morris @HITpolicywonk “Like everyone else I have to read the ONC regs, so I feel a song of the day is appropriate once more. Today, it's The Police, ‘Every Breath You Take.’”

“For folks who say info blocking doesn't exist, consider that every example given in the reg (around pages 360 and following) of something that may be info blocking is most likely something that has actually happened and been reported to ONC.”

Driving the Day

UNSEALED PLANS SHED LIGHT ON BERKMORGAZON PLANS: The Amazon-Berkshire Hathaway-JP Morgan combination is looking at “reinvent[ing] what insurance looks like around benefit design,” said company chief operating officer Jack Stoddard during a hearing regarding the employment status of one of the firm’s fresh hires.

The comments come as part of freshly unsealed court documents arising from a case in which the new hire, David Smith, was sued by his old employer Optum, who allege that Smith is violating his contract’s non-compete, -disclosure, and -solicitation provisions. Optum is seeking a court order barring Smith from working with the combination company while the dispute is in arbitration.

Stoddard’s comments in the unsealed portions describe more fully the interests of the year-old venture that has stoked speculation among health care watchers. While Stoddard emphasized that the company is still exploring its options, he said that “It's very difficult for the employees [of Amazon, Berkshire, and JP Morgan] when we talk to them to be able to understand what's covered, to afford their coverage.”

The company, he explained, is thinking of testing changes in its plan design and seeing whether those tweaks cause patients to adhere to their medication regimens or visit primary care more frequently. Stoddard’s comments were echoed by previously publicly available testimony from Smith, who said that when his new employers first interviewed him, “continuity of care” was one of their “pain points” to solve.

Stoddard also professed confusion that Optum viewed the company as a competitor. In fact, he said, given Optum’s network of primary care physicians, it may ultimately view the company as a partner. Stoddard also suggested that the firm might emphasize purchasing services from other companies, rather than developing its own.

—New task forces: ONC is launching a flotilla of four new task forces to provide recommendations on its new interoperability meeting. But industry requests for a month-long extension to the comment period were rebuffed.

The new task forces will offer recommendations on the information-blocking and certification requirements covered in the proposal, and a third mainly to examine standards for voluntary pediatric health IT certification. A fourth task force was asked to review the new U.S. Core Data for Interoperability proposal. They’re supposed to provide recommendations by late March, around the time the 60-day comment period is slated to end.

—What’s the standard standard?: One newer controversy: which version of FHIR should be used? HITAC member Ken Kawamoto, a senior medical informatician at University of Utah Health, asked ONC officials why they had decided to use release 2.2 of the FHIR standard for their certification update instead of the more recent release 4, which HL7 says will be more permanent and stable. Kawamoto said that 2.2, used by Argonaut and Apple, is a “members only” standard with no potential for public comment. “That could be problematic,” he said.

An ONC official said the agency wanted to select a market-driven standard and that for now that was release 2.2. At HIMSS last week, some experts also raised questions about version 2.2, saying it was not interoperable with version 4. “People are going to buy FHIR thinking everything is interoperable. But FHIR isn’t always interoperable with FHIR,” said Mario Hyland of IT consultant Aegis.

“While I don’t blame ONC for hewing toward the well-established R2, I would not be surprised if in the public debate there is enough enthusiasm and industry commitment to R4 that we are all pleasantly surprised and choose to surge toward R4, rather than being more conservative,” said Kenneth Mandl of Harvard and Boston Children’s Hospital, one of the creators of SMART on FHIR API standard.

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IN CONGRESS

MANDATORY PDMP CHECK LEGISLATION, AND MORE FROM CONGRESS: Here’s the rundown of Wednesday’s happenings in Congress:

—Klobuchar introduces PDMP bill: Democratic presidential aspirant Sen. Amy Klobuchar (D-Minn.) is back for a third try at a bill mandating provider checks of prescription drug monitoring programs. The bill, co-sponsored by Sen. Rob Portman (R-Ohio), also requires pharmacy reporting of opioid prescriptions within 24 hours. Other provisions include a requirement that the PDMP alert providers about worrisome patterns of opioid use, and state interoperability.

Klobuchar has tried on two previous occasions to get a nationwide PDMP bill enacted. In 2019, however, some of its provisions might not be that sweeping: only eight states lack some form of provider mandate, according to the Brandeis PDMP Training and Technical Assistance Center.

—Encouraging a cyber workforce: Rep.Mike Rogers, the ranking member of the House Homeland Security Committee, wants to help fill the estimated 300,000 unfilled cybersecurity jobs nationwide, the Alabama legislator told our Cyber colleague Tim Starks Wednesday. Health care providers have long expressed frustration at the lack of technical help available.

—Takano asking about travel funds: House Veterans' Affairs Committee chair Mark Takano of California wants to know about one VA aide’s travel expenses, citing reporting from Pro Publica in a letter sent out Tuesday. Takano is inquiring as to whether the travel expenses to Washington, D.C. from the aide’s California home were properly attributed. He’d like responses by March 8. Full letter here.

INSIDE THE HUMPHREY BUILDING

OTHER HHS NEWS:

—CMS releases national spending growth estimates: CMS estimates national health care spending will grow at an average of 5.5 percent per year over the next decade, our Health colleague Paul Demko reports. That figure represents a slight rise from recent years. About 6.3 million more Americans will be uninsured, the agency estimates.

—State of HHS speech: Department secretary Alex Azar is slated to give a speech Friday on the state of HHS, the agency announced.

PERSONNEL NOTES: CMS is seeking a chief information security officer; deadline to apply is April 19 … HHS's Office of Inspector General is seeking an attorney with health IT experience ... Telehealth firm MDLive named Dan Monahan, previously an executive with Change Healthcare, as its COO and CFO … Geisinger executive Sanjay Doddamani will be moving to CMMI … Former ONC official Genevieve Morris is advising patient matching startup Verato.

WHAT WE'RE CLICKING

One Arizona patient can’t get her lifesaving medical record because the hospital is closing, reports the Arizona Republic.

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About The Author : Darius Tahir

Darius Tahir is an eHealth reporter for POLITICO Pro. Before joining POLITICO, Darius worked for Modern Healthcare (where he covered health care technology) and the Gray Sheet (where he covered medical devices and digital health).

Darius graduated from Stanford in 2009 — meaning he absorbed just enough sunshine and tech optimism to develop a fascination.